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Member
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Join Date: Jan 2009
Location: Paradise
Posts: 855
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Member
Join Date: Jan 2009
Location: Paradise
Posts: 855
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Quote:
Originally Posted by adult_aq_stenosis
Dear Joanne,
I'm a neurosurgery PA. I have a lot of experience in this area. ACDF is a proven surgical solution for INDICATED operations. You mentioned the disc was small. I assume the side of herniation and level (C5-6) correlated with your symptoms, generally thumb/pointer finger and if weakness, biceps muscle. I assume if you hade 5 epidurals, then you also had physical therapy. I would always go the way of conservative mngt until I could no longer take the symptoms. Real weakness is another category. They should probably be operated on, but numbness or pain you may be able to sit on for a while.
Don't forget that surgery will expose you to the risk of developing adjacent level disease, aka, a herniation one level above or below the surgical fusion. Hope this helps. Age and comorbidities would also be useful for me to consider in your case. Hope this is helpful. Sorry to hear you have positioned yourself against an artificial clock.
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Think I agree with the conservative approach. Some studies show NO difference in outcomes at 1 year for those who had surgery vs. those who did not. Tough call. While I agree that adjacent level accellerated degenerative changes are likely, there are mindless studies out there to refute that. Who knows? I'm 4 yrs post surgery and have no radiographic or clinical changes, yet.
I'm with what's-his-PA, get another opinion and don't rush this! You can always do surgery, you can't undo it! Oh, I speak from a perspective of 23 years experience as a primary health care provider and the recipient of a C5-6 fusion (for HNP with progressive neuro deficit) with great results, following 9 months of failed PT, facet blocks and epi's.
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